AHIP AHM-250 Online Practice Questions and Exam Preparation

AHIP AHM-250 Online Questions & Answers

• Question 21:

  ______________ HMOs can't medically underwrite any group ?incl small groups.

  A. State
  B. Not-for-profit
  C. For-profit
  D. Federally qualified
  B. Not-for-profit

• Question 22:

  All CDHP products provide federal tax advantages while allowing consumers to save money for their healthcare.

  A. True
  B. False
  A. True

• Question 23:

  Health plans sometimes contract with independent organizations to provide specialty services, such as vision care or rehabilitation services, to plan members. Specialty services that have certain characteristics are generally good candidates for health pl

  A. Low or stable costs.
  B. Appropriate, rather than inappropriate, utilization rates.
  C. A benefit that cannot be easily defined.
  D. Defined patient population.
  D. Defined patient population.

• Question 24:

  Which of the following factors have contributed to the limited popularity of FSAs A. "Use it or lose it" provision

  B. Lack of portability
  C. Only self-employed individuals are eligible for establishing FSAs.
  D. Both A andB
  D. Both A andB

• Question 25:

  As part of its utilization management (UM) system, the Poplar MCO uses a process known as case management. The following statements describe individuals who are Poplar plan members: Brad Van Note, age 28, is taking many different, costly medications for

  A. Mr. Van Note, Mr. Albrecht, and Ms. Cromartie
  B. Mr. Van Note and Ms. Cromartie only
  C. Mr. Van Note and Mr. Albrecht only
  D. Mr. Albrecht and Ms. Cromartie only
  C. Mr. Van Note and Mr. Albrecht only

• Question 26:

  One of the distinguishing characteristics of healthcare marketing is that many of the markets for health plans are national, not local markets.

  A. True
  B. False
  B. False

• Question 27:

  The Hill Health Plan designed a set of benefits that it packaged in the form of a PPO product. Hill then established a pricing structure that allowed its product to compete in the small group market, and it developed advertising designed to inform potential

  A. The number of specialists in Hill's network of providers.
  B. The price for the PPO product.
  C. Hill's ability to report utilization data.
  D. Hill's use of brokers to market its PPO product.
  B. The price for the PPO product.

• Question 28:

  What is a mathematical process that involves using a number of hypothetical situations that, in total, will reasonably reflect an event that will occur in real life

  A. Forecasting
  B. Modelling
  C. Both a and b
  D. None of the above
  B. Modelling

• Question 29:

  The existing committees at the Majestic Health Plan, a health plan that is subject to the requirements of HIPAA, include the Executive Committee and the Corporate Compliance Committee. The Executive Committee serves as a long-term advisory body on issues

  A. Both 1 and 2
  B. 1 only
  C. 2 only
  D. Neither 1 nor 2
  B. 1 only

• Question 30:

  HMOs typically employ several techniques to manage provider utilization and member utilization of medical services. One technique that an HMO uses to manage member utilization is

  A. the use of physician practice guidelines
  B. the requirement of copayments for office visits
  C. capitation
  D. risk pools
  B. the requirement of copayments for office visits